GP bait to privatise the NHS

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First rate letter in the Guardian today:

GP commissioning is the bait which Howard Stoate has swallowed whole (Response, 12 January). There are good arguments for greater involvement of GPs in designing healthcare pathways, which is why a quarter of us are already nibbling at the idea. But he fails to mention all the accompanying reforms which cleverly reinforce each other to create the conditions for the marketisation of the NHS, with its attendant profit motive and explosion in transaction costs.

No mention is made of abolition of the fixed national tariff for provision of each service. This will lead to a race to the bottom, where competitive tenders will be won by the cheapest bids, as quality is so difficult to measure. The current fixed tariffs ensure competition on quality alone. No mention of Monitor, the body which will ensure awarding of all contracts is subject to European competition law, so preventing GPs from "anti-competitively" supporting their local hospital, if there is an alternative cheaper private provider.

Choice is an illusion to foster the market for competing providers. As a GP, I am uncertain of quality differences between my local hospital consultants, let alone those from multiple providers. Patients stand little chance of making rational choices when outcome data is so easy to manipulate. They always ask for one good local hospital. GPs will inevitably be guided by health management professionals in their commissioning decisions, which the private sector is eager to exploit. Why didn't the white paper just put a few keen GPs in charge of the existing PCTs and save the £3bn being used to create the conditions for an insidious private takeover of our NHS?

Dr Brian Green

GP, Witney, Oxfordshire

I agree wholeheartedly.

So do the vast majority of GPs.


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